title: Comparison of outcomes of HLA-matched related, unrelated, or HLA-haploidentical related hematopoietic cell transplantation following nonmyeloablative conditioning for relapsed or refractory Hodgkin lymphoma.
abstract: We compared the outcome of nonmyeloablative allogeneic hematopoietic cell transplantation (HCT) for patients with relapsed or refractory Hodgkin lymphoma (HL) based on donor cell source. Ninety patients with HL were treated with nonmyeloablative conditioning followed by HCT from HLA-matched related, n=38, unrelated, n=24, or HLA-haploidentical related, n=28 donors. Patients were heavily pretreated with a median of 5 regimens and most patients had failed autologous HCT (92%) and local radiation therapy (83%). With a median follow-up of 25 months, 2-year overall survivals, progression-free survivals (OS)/(PFS), and incidences of relapsed/progressive disease were 53%, 23%, and 56% (HLA-matched related), 58%, 29%, and 63% (unrelated), and 58%, 51%, and 40% (HLA-haploidentical related), respectively. Nonrelapse mortality (NRM) was significantly lower for HLA-haploidentical related (P=.02) recipients compared to HLA-matched related recipients. There were also significantly decreased risks of relapse for HLA-haploidentical related recipients compared to HLA-matched related (P=.01) and unrelated (P=.03) recipients. The incidences of acute grades III-IV and extensive chronic graft-versus-host disease (aGVHD, cGVHD) were 16%/50% (HLA-matched related), 8%/63% (unrelated), and 11%/35% (HLA-haploidentical related). These data suggested that salvage allogeneic HCT using nonmyeloablative conditioning provided antitumor activity in patients with advanced HL; however, disease relapse/progression continued to be major problems. Importantly, alternative donor stem cell sources are a viable option.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
authors.forename: Lauri M
authors.initials: LM
authors.lastname: Burroughs
authors.forename: Paul V
authors.initials: PV
authors.lastname: O'Donnell
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Sandmaier
authors.forename: Barry E
authors.initials: BE
authors.lastname: Storer
authors.forename: Leo
authors.initials: L
authors.lastname: Luznik
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Symons
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Jones
authors.forename: Richard F
authors.initials: RF
authors.lastname: Ambinder
authors.forename: Michael B
authors.initials: MB
authors.lastname: Maris
authors.forename: Karl G
authors.initials: KG
authors.lastname: Blume
authors.forename: Dietger W
authors.initials: DW
authors.lastname: Niederwieser
authors.forename: Benedetto
authors.initials: B
authors.lastname: Bruno
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pulsipher
authors.forename: Finn B
authors.initials: FB
authors.lastname: Petersen
authors.forename: Rainer
authors.initials: R
authors.lastname: Storb
authors.forename: Ephraim J
authors.initials: EJ
authors.lastname: Fuchs
authors.forename: David G
authors.initials: DG
authors.lastname: Maloney
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000401:mortality; D006680:HLA Antigens; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D006680:HLA Antigens